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Individual

LISA M ELLIOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
3201 TEASLEY LN, STE 202, DENTON, TX 76210-8302
(940) 484-4311
(940) 484-5075
Mailing address
PO BOX 99213, FORT WORTH, TX 76199-0213
(682) 885-4871
(682) 885-3939

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
25244
TX
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
25244
TX

Other

Enumeration date
10/26/2006
Last updated
04/09/2021
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